UNFPA support to Country Programme South Sudan 2023-2025

2023 was the first year of implementation of the UNFPA Country Programme in South Sudan (2023-2025). Sida is providing 47.2 MSEK in flexible funding to be used during the period 1st of January 2023 31st of December 2024. The total budget for the Country Programme is 90 million USD. The UNFPA Country Programme has five outputs with 4-5 indicators each, all measured through a set of milestones. Sidas support to the UNFPA Country Programme in South Sudan is unearmarked, meaning that the contribution is covering a wide range of areas under all outputs. For year 2023, UNFPA has reported that the expected results have been achieved and/or exceeded for all indicators except two. This is a great achievement given the fragile and often volatile context in the country as well as the budget challenges faced during the implementation period. Please see below for a detailed breakdown of outputs, indicators and target milestones. Output level reporting The Country Programme is designed around five key output areas which contributes to accelerating the reduction of the unmet need for family planning, reduction of preventable maternal deaths and reduction of Gender Based Violence (GBV) and other harmful practices. The outputs were identified through an analysis of root causes of the high maternal mortality, the high unmet need for family planning and the high GBV prevalence in the country. Output 1: By 2025, women, youth and marginalized populations have increased access to equitable and people-centered maternal health, family planning, GBV and HIV prevention information and services through a strengthened and robust health system. All output indicators for 2023 were achieved. Some key results include: -162 693 adolescents and youth were reached with SRH/HIV information. -15 501 Female Sex Workers were provided with HIV prevention package of services. -5 148 women and girls were provided with GBV services at the 13 targeted One Stop Centers (OSC) out of which 211 GBV cases were taken to court through the center. Output 2: By 2025, capacities of actors, institutions, and mechanisms are strengthened to address discriminatory gender and social norms to advance gender equality and women and girls agency across humanitarian, development, and peace continuum. All output indicators for 2023 were achieved. Some key results include: -834 service providers were trained on GBV core concept, GBV case management, safe referrals, GBV guiding principles and GBV prevention and mitigation measures. -426 boda boda riders (motorcycle taxis, mainly young men) participated in talking circles on positive masculinity. -Arranging a national cooking competition for men to increase visibility for discussions on social norms. Output 3: By 2025, data systems and evidence especially those related to sexual and reproductive health and rights and GBV and to account for Population changes are strengthened. Four out of five indicators for 2023 were achieved. Some key results include: -Conducted and finalized the national survey on Violence Against Women and Men Prevalence Survey. -200 staff from various ministries were trained on data generation, analysis, and reporting with a specific focus on Health Management Information Systems and GBV. -Supported the Ministry of Finance and Planning in establishing a population unit with three assigned staff. The indicator which was not achieved (existence of the demographic dividend analysis report) was dependent on the Population Estimation Survey being finalized, which was delayed. Sida assess the delay as being outside of UNFPA:s sphere of influence. By the time the annual report was submitted (April 2024) both documents had been finalized. Output 4: By 2025 capacity of actors and systems strengthened to provide timely, peace-responsive, conflict and climate-sensitive lifesaving interventions to crisis-affected populations. Four out of five indicators for 2023 were achieved and one indicator was reported as partially achieved. Some key results include: -294 842 individuals were reached with integrated lifesaving GBV/SRH Services. -42 000 dignity kits were distributed. -950 national and state level leaders were oriented on Minimum Initial Service Package (MISP) for reproductive health in emergencies. -356 Service Providers in humanitarian settings were trained on psychosocial support (PSS). The indicator which was reported as only partially achieved was the existence of a national emergency preparedness, response and disaster risk reduction plan which integrates sexual and reproductive health (including MISP) and GBV responses. UNFPA states that this was due to coordination issues with the Ministry of Humanitarian Affairs and that while GBV-aspects have now been adequately incorporated, there is more work needed to fully integrate SRH-aspects. Output 5: By 2025, youth and adolescents, especially young women facing multiple discrimination are empowered to demand and access their rights to sexual and reproductive health, GBV and harmful practices across humanitarian, development, and peace continuum. All output indicators for 2023 were achieved. Some key results include: -34 960 young people (16 474 in-school and 18 486 out-of-school) were reached with Comprehensive Sexuality Education (CSE) information. -28 institutions were equipped with staff trained in the operationalization of out-of-school CSE for young people. -A total of 21 986 youth participated in events that amplify youth participation in decision making for SRH, FP, Gender Equality, and GBV. General note on results achieved: In addition to the results reported on the CP targets, it should be noted that following the crisis in Sudan and the increasing number of people crossing the border into South Sudan, the Country Programme expanded its lifesaving interventions to new areas, including Renk, Akobo, Pibor, Bor and Wau, to provide timely assistance to vulnerable returnees and refugees at the border crossing, during transit sites and at their final destinations. This is a good example of how flexible funding allows UNFPA to swiftly responds to new crisis and needs. Risks and challenges In 2023, South Sudan continued to experience high levels of inter-communal violence and conflicts. Issues with flooding in large parts of the country remained and the country has now been ranked as the second most vulnerable country to natural hazards in the world according to the 2023 INFORM Risk Index. All of these factors, have had a negative impact on accessibility and hampered service delivery to people in need. The war in Sudan forced close to half a million people to cross the border into South Sudan with an additional 420 000 people anticipated in 2024. The humanitarian crisis continued to deteriorate, with people in need of humanitarian crisis growing from 8.9 million to 9.4 million. In addition, the economic situation has spiraled with the SSP depreciating against the US dollar by 50% during 2023. UNFPA has also reported that the gradual reduction in scope of the Health Pooled Fund (HPF) has resulted in increased demand on facilities who are receiving external support. The additional pressure have been overwhelming and UNFPA reports that critical health services could not be provided for an extended period of time in several of the catchment areas where the HPF used to work. Monitoring and evaluation In 2023, a total of 12 field monitoring visits were conducted by UNFPA, including joint donor visits. Sida joined for one of the field visits (Rumbek) and had planned to join another field visit to Wau which, unfortunately, had to be cancelled last minute. Sida also partook in several visits to programme supported sites in Juba, e.g., the Midwifery college, IDP-camps and local primary health care units. Key observations made by Sida included the limited understanding among some IPs on the purpose of enabling access to family planning services, the underutilization of the tickler file system (a defaulter tracing mechanism used to identify and routinely trace children who miss their immunization appointments) and the Washington Short Set of Questions (to identify potential disabilities among patients) not always being applied correctly. Sida also partook in the quarterly joint donor meetings together with Norway and Canada. These were hybrid meetings which allowed for online participation by the programme officer in Stockholm in addition to the physical presence of the programme specialist in Juba. The programme specialist together with the Head of the Section Office in Juba also joined for the annual review meeting taking place in November 2023. UNFPA stated in their narrative report for 2023 that a key findings from the M&E visits conducted during the year involved the need to address the considerable gaps caused by the withdrawal of HPF-support. Identified gaps included human resources, medicinal supplies and the general management and administration of health facilities, necessitating immediate and targeted interventions. The monitoring visits also highlighted challenges with outreach efforts for community mobilization for SRH/GBV service uptake. In addition, UNFPA have complied to the requirements of the Harmonized Approach to Cash Transfers (HACT) and conducted annual audit for all IPs with over $100,000 grants. As part of a larger effort to address the unmet need for Family Planning (FP) and utilization of modern FP services, UNFPA launched innovation challenges for youths where ten innovation ideas were developed. The ideas will be further tested in 2024 and hopefully used as a part of a scale-up in efforts. Comment on funding modality UNFPA has reported that the funding modality (unearmarked multi-year support) of Sida's contribution to the country programme has enabled predictability and flexibility of activities, as well as implementation of areas of the Country Programme that have faced resource mobilization challenges. In 2023, UNFPA was able to allocate resources and continued implementation of key activities where there were budget constraints and where funding was still being negotiated with various donors. This included (but was not limited to) capacity building for service providers on provision of Minimum Initial Services Package (MISP), the provision of youth friendly SRH services and information in Kapoeta, Juba, Torit and Yambio and support to 13 one stop centers within public health facilities providing multi- sectoral case management services for GBV-survivors. During 2023, UNFPA continued to foster strong partnerships with donors in terms of programme financing and technical contribution to programme development, implementation and monitoring. The donors now include Canada, Sweden, Norway, Japan, Switzerland, European Union (ECHO), South Sudan Humanitarian Fund (SSHF), CERF, USAID, Global Fund, UN Fund and Peace building Secretariat (PBF) and the World Bank. It should be noted that out of all the donors, Sweden and Norway are the only ones providing unearmarked support. Resource mobilization During 2023, UNFPA successfully implemented the integrated partnership and resource mobilization plan. This resulted in the mobilization of an additional 21.4 million USD (159% of the annual target) with 13.4 million USD received for Country Programme implementation during 2023, meaning that UNFPA reached a 99.66% financial coverage of the annual budget. This is a remarkable achievement given the difficult funding situation amidst growing needs. In addition to mobilizing new resources, UNFPA also continued to strengthen their partnership with FAO by exchanging knowledge and experience, e.g., by including FAO partners and staff in GBV training in exchange for UNFPA staff and partners being included in livelihood trainings. This is particularly noteworthy given that Sida is supporting a FAO project partly focused on livelihoods in South Sudan. Meetings were also held with private sector and financial institutions including the African Development Bank, the World Bank and Global Fund to discuss potential funding opportunities.

The overall vision of the UNFPA Country Programme 2023-2025 is that every woman, girl and youth in South Sudan is empowered and enjoys quality sexual and reproductive health and rights and gender equality; and gender-based violence, including child marriage, is reduced. The outputs are identified as follows: Output 1: Women, youth and marginalized populations have increased access to equitable and people-centred maternal health, family planning, gender-based violence and HIV prevention information and services through a strengthened and robust health system.* Output 2: Strengthened capacities of actors, institutions, and mechanisms to address discriminatory gender and social norms and to advance gender equality and women and girls agency, across the humanitarian, development and peace continuum. Output 3: Strengthened data systems and evidence, especially those related to sexual and reproductive health and rights, gender-based violence and population changes. Output 4: Strengthened capacity of actors and systems to provide timely, peace-responsive, conflict and climate-sensitive life-saving interventions to crisis-affected populations. Output 5: Youth and adolescents, especially young women facing multiple forms of discrimination, are empowered to demand and access their rights to sexual and reproductive health and reject gender-based violence and harmful practices, across the humanitarian, development and peace continuum.